SIMP Benefit Summary Detail

WINDOW OVERVIEW:

The Benefit Summary for MEDICAID SIMP/OMB or MN cases is used to view the details of a selected Spousal Impoverishment budget. This view is similar to the paper DA4M budget form.

FIELD DESCRIPTIONS:

Begin Date: The budget month is displayed in the title bar of the window.

Program Case Group Box:

This box displays the first and last name of the Program Case Name person, the MEDICAID program type, the SIMP/OMB or MN category of MED eligibility, and the type of budget (regular or recalculated).

Budget Details Display Box:

Left Side:

Resource Total: This field displays the total amount of resources calculated for the program case.

Resource Limit: This field displays the resource limit established for the program case.

Comm Spouse Income Level: This field displays the income level for the community spouse.

Excess Shelter Allowance: This field displays the any excess shelter allowance (the shelter cost plus utility allowance minus the shelter limit.)

Family Memb Maint Need: This field displays the maintenance need for the dependent family members.

Total: This field displays the total of community spouse income level, excess shelter allowance, and family member maintenance need.

Comm Spouse Total Inc: This field displays the total earned and unearned income of the community spouse and dependent family members.

Actual Comm Spse/Fam Allow: This field displays the total need minus the income of the community spouse and dependent family members.

Unearned Income: This field displays the participant"s unearned income

Unearned Income Disregard: This field displays the unearned income disregard for the participant.

Net Unearned Income: This field displays the participant's unearned income minus any disregards.

Earned Income: This field displays the earned income of the participant.

Earned Income Disregard: This field displays the earned income disregard.

Net Earned Income: This field displays the countable earned income minus the disregard.

Resource Test: This field displays the Pass or Fail status of the resources.

Income Test: This field displays the Pass or Fail status of the income.

Right Side:

Unit Size: This field displays the number of eligible persons in the budget. Double click on this line to see the status of all persons in the case.

Total Net Countable Inc: This field displays the total of countable earned and unearned income.

Medical Income Level: This field displays the medical income level for the participant.

Share of Cost: This field displays the participant's share of cost based on the total countable income minus the medical income level.

Lower of Maximum or Actual Comm Spse/Fam Allow: This field displays either the Actual Community Spouse and Dependent Family Member allowance from the left side or the maximum allowance which ever is lower.

Adjusted Share of Cost: This field displays the Share of Cost minus any medical deductions and the Community Spouse and Dependent Family Member allowance.

Additional Excess Income: This field displays the Adjusted Share of Cost minus the medicaid nursing home per diem amount.

Private Pay Days: This field displays the number of days the participant must pay the nursing home at the private pay rate.

Creation Date: This field displays the date the budget was authorized.

Note: The specifics of many of the line items can be viewed by double clicking on the line. (designated on these pages in navy blue type). Budgets authorized before 07-06-2004 may be displayed in a different format and not all of the fields listed here in navy blue type will open.

ACTION BUTTONS:

OK Select the OK button to close the Benefit Summary window.
Help Select the Help button for window specific Help information.

NFO23

(07-2012)